Description: Essential Health Benefits and Actuarial Value

Description: Medicare Advantage and ACA

Description: This paper describes in detail each of five options available to small Texas employers wanting to purchase insurance for their employees. It then describes the advantages and disadvantages to the various players: carriers, employers, employees, and agents. It points out that each player will act in its own interest.

Description: This is a presentation From 38th Annual Actuarial Research Conference 8/9/2003, University of Michigan, Ann Arbor, Michigan. Pricing health insurance presents numerous statistical problems. This paper develops a non-parametric method for handling these problems. This method involves kernel density estimation of the charge level distribution and also kernel smoothing between the reimbursement function derivatives. It derives some properties of the estimates so obtained. It illustrates the method with some dental data and compares the results to some other simpler estimation techniques.

Description: This work investigates the use of a statistical approach to calculate the incurred but not reported IBNR reserve directly. This allows for the reserve to be estimated in one step, without completion factors, and it provides a confidence interval around the estimate of IBNR as well.

Description: This paper will develop an aggregate claim reserve methodology for health claims. The theoretical nature of the unpaid claim process is outlined and discussed. This is then used to develop a paradigm shift, which views the claim reserve estimation as a projection of claims from one period to another, rather than as a matter of estimating residual unpaid claims from observed paid claims.

Description: Industry briefings and SOA news

Description: The article explores how deeply the Affordable Care Act reduced the Medicare Advantage benchmark payment rates and quantifies how much of that reduction Medicare Advantage Organizations earned back through quality bonuses.

Description: This article summarizes 2012 AAA activities relating to the Affordable Care Act implementation, including work on the Amicus Brief for the Supreme Court Decision, MLR regulations, Actuarial Value, Rate Review, Essential Health Benefits and work with the NAIC.

Description: Article describes how Medicare Medical Savings Plans work and why they would be attractive option for insurance companies.